ICD-10: M67.352

Transient synovitis of the hip, specifically coded as ICD-10-CM M67.352, is a condition characterized by inflammation of the synovial membrane in the hip joint, leading to temporary joint pain and swelling. This condition is most commonly seen in children, particularly those aged 3 to 10 years, but it can also occur in adolescents and adults.

Clinical Description

Definition

Transient synovitis is a self-limiting inflammatory condition of the hip joint, often resulting in pain and reduced mobility. The inflammation typically arises without a clear infectious cause, although it may follow a viral infection or minor trauma.

Symptoms

Patients with transient synovitis of the left hip may present with:
- Hip Pain: Often localized to the left hip, which may worsen with movement.
- Limping: A noticeable limp due to pain or discomfort when walking.
- Limited Range of Motion: Difficulty in moving the hip joint, particularly in internal rotation and abduction.
- Swelling: Mild swelling may be observed around the hip area, although it is not always prominent.

Diagnosis

Diagnosis of transient synovitis involves:
- Clinical Examination: Assessment of symptoms, physical examination, and evaluation of the hip's range of motion.
- Imaging Studies: Ultrasound or MRI may be utilized to assess joint effusion and rule out other conditions such as septic arthritis or osteomyelitis.
- Laboratory Tests: Blood tests may be performed to check for signs of infection or inflammation, although these are typically normal in transient synovitis.

Treatment

Management of transient synovitis generally includes:
- Rest: Limiting weight-bearing activities to reduce stress on the hip joint.
- Pain Management: Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed to alleviate pain and inflammation.
- Physical Therapy: Gentle exercises may be recommended to restore mobility once acute symptoms improve.

Prognosis

The prognosis for transient synovitis is generally favorable, with most patients experiencing complete recovery within a few weeks. However, follow-up is essential to monitor for any potential complications or recurrence.

Coding Details

The ICD-10-CM code M67.352 specifically denotes transient synovitis affecting the left hip. This code is part of the broader category of codes related to other specified disorders of synovium and tendon, indicating the need for precise documentation in medical records for accurate billing and treatment tracking.

In summary, transient synovitis of the left hip (ICD-10-CM M67.352) is a common, self-limiting condition primarily affecting children, characterized by hip pain and inflammation. Early diagnosis and appropriate management are crucial for a swift recovery and to prevent complications.

Transient synovitis of the hip, classified under ICD-10 code M67.352, is a common condition primarily affecting children, characterized by inflammation of the synovial membrane in the hip joint. Understanding its clinical presentation, signs, symptoms, and patient characteristics is crucial for accurate diagnosis and management.

Clinical Presentation

Demographics

Transient synovitis typically occurs in children aged 3 to 10 years, with a higher prevalence in boys than girls. It is often associated with a recent viral infection, such as upper respiratory infections, which may precede the onset of symptoms[1][2].

Symptoms

Patients with transient synovitis usually present with the following symptoms:

• Hip Pain: The most common complaint is hip pain, which may be localized or referred to the groin, thigh, or knee. The pain can be acute and may worsen with movement.
• Limping: Children often exhibit a limp due to pain and discomfort in the affected hip. This may be more pronounced during physical activity.
• Limited Range of Motion: There may be a noticeable reduction in the range of motion of the hip joint, particularly in internal rotation and abduction.
• Swelling: Although not always present, some patients may exhibit mild swelling around the hip joint.

Signs

Upon physical examination, healthcare providers may observe:

• Tenderness: Palpation of the hip joint may elicit tenderness, particularly in the groin area.
• Decreased Mobility: The child may resist movement of the hip joint due to pain, and passive range of motion may be limited.
• Positioning: The affected leg may be held in a flexed and externally rotated position to minimize discomfort.

Patient Characteristics

Risk Factors

Several factors may increase the likelihood of developing transient synovitis:

• Recent Viral Illness: A history of recent viral infections, particularly respiratory infections, is commonly reported in affected children[3].
• Age and Gender: As mentioned, the condition predominantly affects younger children, especially males.
• Family History: A family history of hip disorders or transient synovitis may also be a contributing factor.

Differential Diagnosis

It is essential to differentiate transient synovitis from other conditions that may present similarly, such as:

• Septic Arthritis: This is a more severe condition that requires immediate intervention and is characterized by fever, severe pain, and systemic signs of infection.
• Perthes Disease: Avascular necrosis of the femoral head, which typically presents with hip pain and limping but has a different underlying pathology.
• Fractures: Trauma-related injuries should also be considered, especially in active children.

Conclusion

Transient synovitis of the hip (ICD-10 code M67.352) is a self-limiting condition that requires careful evaluation to rule out more serious pathologies. Recognizing the typical clinical presentation, including age, symptoms, and signs, is essential for timely diagnosis and management. If transient synovitis is suspected, supportive care and monitoring are usually sufficient, as the condition often resolves spontaneously within a few weeks[4].

When discussing the ICD-10 code M67.352, which refers to Transient synovitis of the left hip, it is helpful to understand the alternative names and related terms that may be used in clinical settings. Here’s a detailed overview:

Alternative Names

1. Transient Synovitis of the Hip: This is a broader term that encompasses transient synovitis affecting either hip joint, not limited to the left side.
2. Transient Synovitis: A general term that can refer to the condition affecting any joint, though it is often specified by location (e.g., hip, knee).
3. Iliopsoas Bursitis: While not identical, this term may sometimes be used interchangeably in discussions about hip pain, as it can present similarly.
4. Hip Synovitis: A more general term that refers to inflammation of the synovial membrane in the hip joint, which can include transient synovitis.

Related Terms

1. Coxitis: This term refers to inflammation of the hip joint and can sometimes be used in the context of transient synovitis.
2. Aseptic Hip Arthritis: This term may be used to describe the condition when it is not caused by an infection, which is relevant in the context of transient synovitis.
3. Pediatric Hip Pain: Since transient synovitis is more common in children, this term is often associated with the condition in pediatric populations.
4. Synovial Fluid Analysis: This diagnostic term relates to the examination of synovial fluid, which can help differentiate transient synovitis from other conditions.

Clinical Context

Transient synovitis is often seen in children and can present with hip pain, limping, and reduced range of motion. It is typically self-limiting, but understanding the terminology surrounding it can aid in accurate diagnosis and treatment. The ICD-10 code M67.352 specifically denotes the left hip, which is crucial for billing and coding purposes in healthcare settings.

In summary, while M67.352 specifically refers to transient synovitis of the left hip, various alternative names and related terms exist that can provide context and clarity in clinical discussions. Understanding these terms can enhance communication among healthcare professionals and improve patient care.

Transient synovitis of the hip, classified under ICD-10 code M67.352, is a condition characterized by inflammation of the synovial membrane in the hip joint, typically affecting children. The diagnosis of transient synovitis involves several criteria, which can be categorized into clinical, radiological, and laboratory assessments.

Clinical Criteria

1. Age: Transient synovitis predominantly occurs in children, usually between the ages of 3 and 10 years.
2. Symptoms: Patients typically present with:
   - Hip pain, which may be referred to the knee.
   - Limping or difficulty in weight-bearing.
   - Limited range of motion in the hip joint.
3. Onset: Symptoms often develop acutely, sometimes following a viral infection or minor trauma.

Radiological Criteria

1. Imaging Studies:
   - Ultrasound: A point-of-care hip ultrasound can be particularly useful in diagnosing transient synovitis. It may reveal joint effusion, which is a key indicator of inflammation in the hip joint[4].
   - X-rays: While X-rays may appear normal in cases of transient synovitis, they are essential to rule out other conditions such as septic arthritis or osteomyelitis.

Laboratory Criteria

1. Blood Tests:
   - Inflammatory Markers: Elevated levels of inflammatory markers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) may be observed, indicating an inflammatory process.
   - White Blood Cell Count: A normal white blood cell count can help differentiate transient synovitis from septic arthritis, where leukocytosis is typically present.

Differential Diagnosis

It is crucial to differentiate transient synovitis from other conditions that can present similarly, such as:
- Septic Arthritis: This is a more serious condition that requires immediate intervention. It is characterized by fever, significant pain, and often a high white blood cell count.
- Perthes Disease: Avascular necrosis of the femoral head, which typically presents with hip pain and limping but has a different underlying pathology.

Conclusion

The diagnosis of transient synovitis of the hip (ICD-10 code M67.352) relies on a combination of clinical evaluation, imaging studies, and laboratory tests. Accurate diagnosis is essential to ensure appropriate management and to rule out more serious conditions such as septic arthritis. If you suspect transient synovitis, it is advisable to consult a healthcare professional for a thorough assessment and diagnosis.

Transient synovitis of the hip, particularly when classified under ICD-10 code M67.352, refers to a temporary inflammation of the synovial membrane in the hip joint, often seen in children. This condition can lead to hip pain and limping, and while it is generally self-limiting, appropriate management is essential to alleviate symptoms and prevent complications.

Overview of Transient Synovitis

Transient synovitis is characterized by the sudden onset of hip pain, often following a viral infection or minor trauma. The exact cause is not always clear, but it is believed to involve inflammatory processes that affect the synovial fluid and membrane. The condition is most common in children aged 3 to 10 years and can mimic more serious conditions such as septic arthritis, making accurate diagnosis crucial.

Standard Treatment Approaches

1. Initial Assessment and Diagnosis

• Clinical Evaluation: A thorough history and physical examination are essential. Symptoms typically include hip pain, limping, and reduced range of motion.
• Imaging Studies: Ultrasound or MRI may be used to assess the hip joint for effusion or other abnormalities. X-rays can help rule out fractures or other bone-related issues.

2. Rest and Activity Modification

• Activity Limitation: Patients are usually advised to limit weight-bearing activities to reduce stress on the hip joint. Crutches may be recommended to assist with mobility while minimizing pain.
• Rest: Adequate rest is crucial for recovery, allowing the inflammation to subside.

3. Pain Management

• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Medications such as ibuprofen or naproxen are commonly prescribed to manage pain and reduce inflammation. Dosage should be adjusted based on the patient's age and weight.
• Acetaminophen: This can be used as an alternative for pain relief, especially in younger children.

4. Physical Therapy

• Rehabilitation Exercises: Once acute symptoms improve, physical therapy may be initiated to restore range of motion and strengthen the hip muscles. Gentle stretching and strengthening exercises can help facilitate recovery.

5. Monitoring and Follow-Up

• Regular Follow-Up: Patients should be monitored for improvement in symptoms. Follow-up visits may include repeat imaging to ensure that the condition is resolving and to rule out complications.
• Education: Parents and caregivers should be educated about the condition, including signs of worsening symptoms that may require immediate medical attention.

6. Surgical Intervention (Rare)

• Indications for Surgery: In rare cases where there is significant joint effusion or if the diagnosis is uncertain (to rule out septic arthritis), surgical intervention such as arthrocentesis (joint aspiration) may be necessary to relieve pressure and obtain synovial fluid for analysis.

Conclusion

Transient synovitis of the hip, classified under ICD-10 code M67.352, is typically managed conservatively with rest, pain management, and physical therapy. Most children recover fully within a few weeks, but ongoing monitoring is essential to ensure proper healing and to address any potential complications. If symptoms persist or worsen, further evaluation may be warranted to rule out other conditions.